The Chaos That Sepsis-3 Has Wrought

To the Academy: I understand why the changes were made, and they have caused so much upheaval

Photo by Marcelo Leal on Unsplash

In 2016, a new definition for sepsis was published by a task force convened by the European Society of Intensive Care Medicine and the U.S.-based Society of Critical Care Medicine. The task force’s job, as noted in the article, was to “differentiate sepsis from uncomplicated infection and to update definitions of sepsis and septic shock to be consistent with improved understanding of the pathobiology.”

Prior to this publication, sepsis was defined the presence of a known or suspected infection, with two or more SIRS criteria. SIRS stands for the “Systemic Inflammatory Response Syndrome,” and it is typically defined as two or more of the following:

Temperature greater than 38°C or less than 36°C

Heart rate greater than 90/min

Respiratory rate greater than 20/min or Paco2 less than 32 mm Hg (4.3 kPa)

White blood cell count greater than 12 000/mm3 or less than 4000/mm3 or >10% immature bands

Reference: Bone RC, Balk RA, Cerra FB, et al. American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference: definitions for sepsis and organ failure and…